Organ Donors In Short Supply

February 2, 2004

By Matt Conn

Marshfield News-Herald

Jack Walden of Marshfield plans for a long retirement, now that he's had the chance to see his children through school.

"The transplant made me a new person," he said. "Right now, I feel there's nothing I can't do." Walden, 62, suffered from cardiomyopathy, an enlargement of his heart cavity, which weakens the heart's ability to pump blood. On March 4, 1991, a day he remembers well, Walden received a new heart in Minneapolis.

For patients with failing hearts despite other therapies, the remaining option - the transplant - can restore an individual's vitality, said Dr. Peter Smith, Marshfield Clinic electrophysiologist and director of the Heart Failure Unit at Saint Joseph's Hospital.

"The good thing about a heart transplant is it returns a person almost back to normal from being an incredibly sick heart patient," he said. "They return back to an almost normal survival curve." Bill Reigel, 65, of Mosinee had a heart attack at 41. Eight years later he received CPR from a California man until the defibrillator arrived at New York's LaGuardia Airport, where Reigel had suffered a major cardiac arrest. In 1989, he had an implantable defibrillator installed, then a pacemaker when it failed. Cardiomyopathy set in. In early 1991, he was on the list for a transplant.

"May 11, I was playing cards with my neighbors and my pager went off," he said. "I was told there was a heart waiting for me. At that point I don't think I needed a transplant, my heart was beating so fast." About 200,000 patients in the United States need heart transplants each year, but few are served by the little more than 2,000 hearts available, Smith said.

According to the American Heart Association, 2,199 heart transplants were performed in the U.S. in 2001, and 2,154 in 2002. About 77 percent of patients were male.

These statistics make it quite obvious that any healthy individual should be a donor, Smith said. Most hearts come from auto crashes, he said.

The transplant procedure actually poses fewer challenges than the more technical bypass surgery. During a transplant, physicians sew relatively large vessels together, rather than the fine conduits in arteries during a bypass, Smith said.

The problems come after surgery.

Heart transplant patients must undergo immunosuppressive therapy - a battle with the body's natural rejection of foreign objects - for the rest of their lives. The immune system attacks the new heart.

Reigel takes about 22 pills a day.

"One of the drawbacks to organ transplant is the cost of medication," Reigel said. "I run about an average of $1,000 a month." Anti-rejection drugs have side effects which Walden, an outpatient pharmacy manager at Saint Joseph's, combats with other drugs, which have side effects.

One immunosuppressive drug increases his blood pressure, so he takes a blood pressure pill, which causes bone loss, so he takes calcium, which causes constipation, so he takes stool softeners.

Four times a year, he heads to the clinic for monitoring. Fortunately, he's had no rejection problems, Walden said.

With so many heart failure patients, now at 5 million with a new 500,000 every year, Smith said new procedures, such as left ventricle assist devices used to augment heart muscle pumping for those awaiting transplants, might become therapeutical. But that's still in investigation stages, he said.

Matt Conn can be reached at 384-3131 or 800-967-2087, ext. 328, or at matt.conn@cwnews.net.

On the Web: For more information on organ donations or transplants visit Wisconsin Donor Network.

Copyright © 2003 Gannett Wisconsin Online.

This article posted February 28, 2004.